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Organization

SUPPORT SOLUTIONS OF GEORGIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LARRY DURBIN ED (CHIEF EXECUTIVE OFFICER)
(901) 383-9193
Entity
Organization

Contact information

Practice address
207 PITCARIN WAY, AUGUSTA, GA 30909-5767
(706) 396-0584
(706) 396-0544
Mailing address
207 PITCARIN WAY, AUGUSTA, GA 30909-5767
(706) 396-0584
(706) 396-0544

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
CLA000914
GA
253Z00000X
In Home Supportive Care Agency
121-R-1009
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003121917B
GA
Enumeration date
03/15/2013
Last updated
03/15/2013
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